The ClaimAid Advantage: National healthcare – June Update

In less than 4 months, the “Health Insurance Marketplace” will begin open enrollment as required by the Affordable Care Act (ACA). In 2014, most Americans will be required to purchase or enroll in health coverage. As part of our ongoing commitment to our clients, we are pleased to announce several enhanced services that will ensure you have the information and resources needed throughout this transition. Our goal remains to provide you and your patients / clients / consumers with the ClaimAid Advantage.

ClaimAid will provide “Full Service” enrollment, including options available through the Health Insurance Marketplace.

  • The ACA combines multiple health care reimbursement programs into the Health Insurance Marketplace. Individuals and families may now qualify for premium tax credit commercial insurance, cost sharing assistance, Medicaid or a combination of these.
  • What you need to know: The current Medicaid enrollment processes and procedures will remain in place along with the new Marketplace. New training, testing and certification is required for those providing application assistance. Many individuals and families will change eligibility status throughout the year due to variations in income, family size or the availability of other insurance.  ClaimAid staff will continue to seamlessly guide patients through this dynamic new process.

Medicaid, Healthy Indiana Plan and Hoosier HealthWise for expanded populations

  •  The ACA makes significant changes to both state and federal eligibility requirements for Medicaid and other health care reimbursement programs.
  • What you need to know: Indiana has submitted a proposal for expanding the eligibility criteria of Medicaid using the Healthy Indiana Plan (HIP). The public comment period has recently closed and the federal Centers for Medicare and Medicaid Services (CMS) will now consider the proposed plan. Even if Indiana does not expand Medicaid using HIP, new federal income guidelines and enrollment mandates will result in expanded eligibility. ClaimAid has the experience, training and up-to-date information to assist patients with the new enrollment criteria.

Navigators and Certified Application Counselors

  • In accordance with the ACA timeline, ClaimAid staff will hold the appropriate federal and state certification credentials necessary to assist your patients every step of the way.
  • What you need to know: New regulations require proper due diligence, training, federal and state examinations, certification and continuing education to provide individuals and families with enrollment assistance in the Marketplace. ClaimAid advocates will achieve these objectives as well as meet conflict of interest, ethical and legal standards.

Provider and Patient Education

  • Much of the ACA implementation is still being defined with new proposed rules and regulations being issued. A recent survey found that 4 in 10 Americans remain unaware that requirements of the ACA are still in place.
  • What you need to know: This unstable environment has been a concern for both businesses and consumers. ClaimAid will continue to work with both to facilitate enrollment into an appropriate coverage option. Contact us now to schedule a time to meet with your team to discuss your strategic plans for transition.

For more details and up-to-date information, please contact J Hopkins, Vice President at 800.842.4052 x126 or by email at